4FW-65200-73101

2 vaccinations 7 coded responses 23 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 489 / MI
Registered: 2021-03-13

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Janssen/Johnson & Johnson
2021-03-13
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Tremor — Feeling: Poor · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shacky

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Fair

Free text: I'm just feeling a little fatigued. It's not preventing me from carrying on with my daily routine but I seem to be tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 21, single dose
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: I'm just feeling really fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-17
Survey response — day 35, single dose
MedDRA: Headache, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Headache on the right side behind my ear but I think it's something else because I've had this before. I don't think this is associated with my covid-19 vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2021-09-13
Survey response — 6 months, dose 1
MedDRA: Emergency care, Hypoaesthesia oral, Office visit, Paraesthesia oral — Feeling: Good · Be unable to do your normal daily activities

Free text: The inside of my mouth kept tingling and was numb. I went to the ER but it was not my heart or a stroke so they sent me to follow up with my family doctor. He put me on an antibiotic and those symptoms went away.

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Dose 2 — Pfizer-BioNTech
2021-11-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-06
Survey response — day 14, dose 2
MedDRA: Ear pain, Emergency care, Facial pain, Neurological symptom, Office visit — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Pain on the left side of my face from the middle of my chin to my earlobe. I had to go to Urgent Care, the dentist, and the hospital, and they think it's a neurological conditions not associated with the vaccination · Healthcare visit (other): Dentist

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Report sent to call center — day 14, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-11-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-11-20
Survey response — day 28, dose 2
MedDRA: Pain in jaw — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pain in my jaw

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — day 28, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-23
Call 1 — Left Voicemail
2021-11-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Janssen/Johnson & Johnson
2	2021-10-23	Pfizer-BioNTech	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): Shacky

Release 6 — day 14, dose 1

2021-03-27

Symptoms: I'm just feeling a little fatigued. It's not preventing me from carrying on with my daily routine but I seem to be tired

Release 6 — day 21, single dose

2021-04-03

Symptoms: I'm just feeling really fatigued

Release 7 — day 35, single dose

2021-04-17

Symptoms: Headache on the right side behind my ear but I think it's something else because I've had this before. I don't think this is associated with my covid-19 vaccine

Release 9 — 6 months, dose 1

2021-09-13

Symptoms: The inside of my mouth kept tingling and was numb. I went to the ER but it was not my heart or a stroke so they sent me to follow up with my family doctor. He put me on an antibiotic and those symptoms went away.

Release 10 — day 14, dose 2

2021-11-06

Symptoms: Pain on the left side of my face from the middle of my chin to my earlobe. I had to go to Urgent Care, the dentist, and the hospital, and they think it's a neurological conditions not associated with the vaccination

Healthcare visit (other): Dentist

Release 10 — day 28, dose 2

2021-11-20

Symptoms: Pain in my jaw

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Office visit	·	·	✓
SD	Ear pain	·	·	✓
SD	Emergency care	·	·	✓
SD	Facial pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia oral	·	·	✓
SD	Neurological symptom	·	·	✓
SD	Office visit	·	·	✓
SD	Pain in jaw	·	·	✓
SD	Paraesthesia oral	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Tremor	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release